<div id="central_content"> 
      
      <!-- BEGIN central slogan and rss feed -->
      <div class="question1 ha">Check Out</div>
      <div class="question2 ha">Full Elements</div>
      <div style="clear:both;"></div>
      
      <!-- END central slogan and rss feed --> 
      
      <!-- START #central_content-->
      <div style="clear:both;  padding:0 0 24px 0; margin:0; line-height:24px;"></div>
      <form action="checkout">
        <div class="form_left">
          <div class="check_label">Name:*</div>
          <input type="text" class="check_input" name="name"/>
          
          <div class="check_label">E-Mail:*</div>
          <input type="text" class="check_input" name="email"/>
          
          <div class="check_label">Telephone:*</div>
          <input type="text" class="check_input" name="telephone"/>
          
        </div>
        <div class="form_right">
          <div class="check_label">Address:*</div>
          <input type="text" class="check_input" name="address"/>
          
          
          <div class="check_label">Company:</div>
          <input type="text" class="check_input" name="company"/>
          
          
          <div style="padding:17px 0 0 0;"></div>
        </div>
      </form>
      <div class="checkout_button" style="margin-top:28px; margin-bottom:10px;"><a href=""><img class="checkout_icon" src="public/images/check.png" alt="check"/>Go to Checkout</a></div>
      <div style="border-bottom:1px solid #ECE9E9; height:1px; padding:34px 0 0 0; margin:0px 0 0px 0; clear:both;"> </div>
      <div style="padding:17px 0 0 0;"></div>
      <div class="comments_text he">Add Comments </div>
      <span class="comments_text2 he">About Your Order</span>
      <textarea class="check_textform" cols="10" rows="5"></textarea>
      
      <!-- END #central_content--> 
    </div>